Australia's dysfunctional health system

The AMA, colleges, representative bodies of other health practitioners, politicians and media are not interested in the dysfunctionality of the health regulatory system.

These bodies have shown a distinct disinterest in the workings of the regulator of health practitioners. Why is this so?

The AMA, colleges and other health practitioner bodies placed ethical and professional behaviour foremost in their priorities in the distant past. They now profess to address failings, such as bullying and abuse of the notification process of the regulator, AHPRA, as one of their priorities. Actions speak louder than words and protestations of intolerance of such actions is mere window dressing as evidenced by their failure to take decisive action against members who transgress.

Politicians have not demonstrated a willingness to intervene to correct the serious problems that exist within AHPRA; these are systematic and deny due process, natural justice and presumption of innocence to those who are subjects of notification. The Senate inquiries of 2016 and 2017 confirmed that many problems exist with the processes used by AHPRA. Unsurprisingly, there has been no action from the Federal Parliament from any of the political identities to address the serious issues identified by the numerous submissions received by the inquiries. These can be accessed from the parliamentary record of Senate inquiry proceedings.

There appears to be an unwarranted awe of the AMA and colleges that presupposes their interest in the vexed situation existing in AHPRA. Membership of the AMA is held by a small percentage of medical practitioners and they do not represent a very sizable proportion of the profession. The colleges pay lip service to interest but do not take any action to combat the problem. Both the AMA and the colleges no longer place ethics and professional behaviour high on there list of priorities — the focus for them is on there business models and incomes.

The media has demonstrated no interest in this problem despite the negative impact that it is having on delivery of health services to our communities. It is time for a change.

LIST OF HPARA RECOMMENDATIONS

Recommendation 1

4.25 The committee recommends that all parties with responsibility for addressing bullying and harassment in the medical profession, including governments, hospitals, speciality colleges and universities:

acknowledge that bullying and harassment remains prevalent within the profession, to the detriment of individual practitioners and patients alike;

recognise that working together and addressing these issues in a collaborative way is the only solution; and

commit to ongoing and sustained action and resources to eliminate these behaviours.

Recommendation 2

4.27 The committee recommends that all universities adopt a curriculum that incorporates compulsory education on bullying and harassment.

Recommendation 3

4.30 The committee recommends that all universities accept responsibility for their students while they are on placement and further adopt a procedure for dealing with complaints of bullying and harassment made by their students while
on placement. This procedure should be clearly defined and a written copy provided to students prior to their placement commencing.

Recommendation 4

4.32 The committee recommends that all hospitals review their codes of conduct to ensure that they contain a provision that specifically states that bullying and harassment in the workplace is strictly not tolerated towards hospital staff, students and volunteers.

Recommendation 5

4.35 The committee recommends that all specialist training colleges publicly release an annual report detailing how many complaints of bullying and harassment their members and trainees have been subject to and how many sanctions the college has imposed as a result of those complaints.

Recommendation 6

4.37 The committee recommends that a new inquiry be established with terms of reference to address the following matters:

the implementation of the current complaints system under the National Law, including role of AHPRA and the National Boards;

whether the existing regulatory framework, established by the National Law, contains adequate provision for addressing medical complaints;

the roles of AHPRA, the National Boards and professional organisations – such as the various Colleges – in addressing concerns within the medical profession with the complaints process;

the adequacy of the relationships between those bodies responsible for handling complaints;

whether amendments to the National Law in relation to the complaints handling process are required; and

other improvements that could assist in a fairer, quicker and more effective medical complaints process.